Anesth Pain Med.  2021 Jul;16(3):284-289. 10.17085/apm.21008.

Tachycardia-polyuria syndrome after swan-ganz catheterization in liver transplant patient - A case report -

• Heo SK
• Kim KS
• Lee JH
• Song JG

• KMID: 2519058
• DOI: http://doi.org/10.17085/apm.21008

Abstract

Background
Tachycardia-polyuria syndrome is characterized by polyuria occurring because of tachycardia with a heart rate of ≥ 120 beats/min lasting ≥ 30 min. We report such a case occurring after swan-ganz catheterization. Case: A 41-year-old male was scheduled for living-donor liver transplantation. After general anesthesia, atrial fibrillation occurred during swan-ganz catheterization, and polyuria developed 1 h later. During the anhepatic phase, the patient’s heart rate increased further, and cardioversion was performed. After a normal sinus rhythm was achieved, the patient’s urine output returned to normal.
Conclusions
The patient’s polyuria seemed related to the iatrogenic atrial fibrillation occurring during swan-ganz catheterization. Although we did not measure atrial natriuretic peptide, an increase in its concentration may have been the main mechanism of polyuria, as natriuresis was observed.

Keyword

Antidiuretic hormone; Atrial fibrillation; Atrial natriuretic peptide; Polyuria; swan-ganz catheter

Figure

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  Fig. 1. This is atrial fibrillation occurred when swan-ganz catheter was inserted. ECG: electrocardiogram, ABP: arterial blood pressure.

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  Fig. 2. This is atrial fibrillation occurred when swan-ganz catheter was re-inserted. ECG: electrocardiogram, ABP: arterial blood pressure.

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  Fig. 3. Chart showing the heart rate, urine analysis, urine output and blood test changes. HR: heart rate, U/O: urine output, ADH: antidiuretic hormone.

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  Fig. 4. This is a normal sinus rhythm returned after direct current cardioversion. ECG: electrocardiogram, ABP: arterial blood pressure.

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